PROJECT SUMMARY/ABSTRACT In 2012 South Dakota ranked #50 in infant mortality, #49 in neonatal mortality and #46 in postneonatal mortality despite having one of the lowest rates of low birthweight deliveries (#5) and preterm births (#16). A Governor's Task Force on Infant Mortality was formed in 2011 with the First Lady serving as the Chairperson. Several recommendations resulted, including a recommendation to enhance state and county- level data regarding pregnancy experiences, risk, barriers, outcomes and infant care practices. Historically, there have been little data available on factors that influence health behaviors and attitudes of South Dakota mothers around the time of pregnancy. The South Dakota Department of Health (SDDOH) recognized that the PRAMS survey is a tool to provide that information and in 2013 contracted with the Ethel Austin Martin (EAM) Program at South Dakota State University (SDSU) to provide Maternal and Child Health (MCH) epidemiological services and to conduct the first statewide 2014 SD PRAMS (sample stratified by race [White, American Indian, Other Races]). The 2014 SD PRAMS was successful and obtained a statewide weighted response rate of 71.3%. The 2014 SD PRAMS data are currently being used by the MCH Team in their development of MCH Block Grant State Performance Measures. Domestic violence data are being analyzed for the Sexual Violence/Rape Prevention Education group, and data on smoking and alcohol use are being used by the Office on Chronic Disease Prevention and Health Promotion. The current proposal is for South Dakota to serve as a Core Surveillance site (Component A) in the CDC PRAMS. The CDC PRAMS proposal will involve significant collaboration with EAM/SDSU and the Northern Plains Tribal Epidemiology Center, similar to the 2014 SD PRAMS. The need is significant, the data are being used, and we have an excellent statewide participation rate.